The Perfect Step, Rehabilitation, and Equitable Access to Fitness with Hal Hargrave
In this episode, Hal Hargrave, founder of The Perfect Step, shares how a life-altering spinal cord injury at 17 became the catalyst for building one of the nation’s leading centers for neurological recovery and inclusive rehabilitation. What began as his own journey toward recovery evolved into a mission to create an affordable, holistic model of care, one that integrates exercise-based therapy, mental health, chiropractic care, acupuncture, and massage for individuals living with paralysis, stroke, traumatic brain injury, and other neurological conditions. Hal’s story highlights how inclusive fitness can be both compassionate and commercially viable, bridging the gap between healthcare and community wellness.
Hal dives deep into the business model behind The Perfect Step, explaining how his team built a turnkey, scalable solution that allows health clubs and rehabilitation facilities to integrate adaptive programs without needing costly renovations or specialized equipment. He discusses their proprietary STEP Certified Paralysis Recovery Specialist program, a structured four-tier education system rooted in load-bearing science, neuroplasticity, and pattern neural activity recruitment (PNAR). The program not only empowers fitness professionals to support individuals with spinal cord injuries and other conditions but also challenges the misconception that inclusion requires extensive resources—emphasizing instead that education, mindset, and people are the true keys to accessibility.
Throughout the conversation, Hal and host Brendan Aylward explore the value proposition of inclusion, the symbiotic relationship between for-profit and nonprofit models through the Be Perfect Foundation, and the measurable outcomes that prove adaptive fitness is good business. Hal’s story is one of purpose, resilience, and redefining success after disability, showing how recovery is not just physical, but mental, emotional, and social. This episode is essential listening for fitness professionals, healthcare providers, and entrepreneurs seeking to make their work more inclusive, evidence-based, and impactful.
Brendan Aylward (00:01.515)
All right. Welcome to the AdaptX podcast where we have conversations with individuals who are building accessible businesses, advocating for inclusion or excelling in adaptive sports. Our intention is never to speak on behalf of those with disabilities, but provide a platform to amplify their voice and share their ideas to a more accessible world. Today, we are joined by Hal Hargrave. Hal is the owner and founder of The Perfect Step and presently serves as a role of facilities manager and as a board member for The Perfect Step's corporate team. Hal became a part of the team back in 2007.
shortly after he sustained a spinal cord injury in an auto accident. Hal was approached by Mike Alpert and the Claremont Club in an effort to try and provide treatment to Hal and be a part of his ongoing therapy, regiment and recovery. Hal, thank you for joining me today.
Hal Hargrave (00:42.974)
Pleasure to be on. I'm looking forward to our conversation.
Brendan Aylward (00:46.207)
So let's maybe introduce the listener to what the perfect step is. So just global vision of what the business provides as a service.
Hal Hargrave (00:57.818)
I think the global vision is this, and I've been noted to say this recently, but our intention is to become the largest neurological recovery network in the chronic stage of recovery in the world.
we have that type of affluence and thought and idea out of the mere sake of wanting to provide affordable health care in every major region across the world to people who are living with debilitating needs. So the perfect step exists to intend...
to provide an inclusive program option for people that are living in the chronic stage of recovery with varying levels of neurological disorders resulting in paralysis. So we treat an array of different areas of treatment in terms of diagnosis or injuries, ranging from spinal cord injury, stroke and traumatic brain injuries are our top three getters in terms of the individuals that we serve, and those are all onset by injury. And some of the other diagnoses
that we treat that have been diagnosed by way of disease or onset at time of birth would be things like cerebral palsy, multiple sclerosis, ALS or PLS, hereditary spastic paraplegia, ataxia, Parkinson's and more. And so we provide an inclusive program treatment option for those in the chronic stage who are seeking a high intensity approach towards recovery and care
very reminiscent of that of a very holistic model and approach where we address the whole mind, body, and soul. And we provide disciplines here at our flagship location to that of our physical model of care, which our specialists are working one-on-one with our particular clientele. And we also have other holistic service options on site here in the form of chiropractic, acupuncture, massage therapy, and mental health therapists on site to provide
Hal Hargrave (02:59.072)
a very holistic approach towards recovery.
Brendan Aylward (03:02.619)
So what's the business model? Are you a non-profit entity? Are you a for-profit entity? Do you leverage insurance? Is it cash-based?
Hal Hargrave (03:12.838)
Yeah, so we are currently a for-profit entity.
With current makings of expanding on a national level through licensing options of our facility, we have a turnkey solution for prospective businesses or existing organizations to be able to seamlessly integrate this into their commercial health club location or medical fitness facility. Or even those that are interested in a freestanding facility option, we do have those opportunities
us. We do accept insurance, rather it's really up to the constructs of the insurance company to requisite believe if we are a reimbursable model of care to their standards. We have had luck with insurance reimbursement particularly with the state of California and Workman's compensation has been very advantageous to our clients to be able to get full coverage of care at our facility. Otherwise we are an out-of-pocket pay
a fee-for-service model where clients pay hourly as they go.
Brendan Aylward (04:21.775)
You mentioned a turnkey solution that could be implemented within a commercial health club. Is there unique or specialized adaptive equipment that those facilities would have to purchase or add to be able to adopt your model?
Hal Hargrave (04:34.983)
Yeah, so.
For sure. You know, when we say turnkey, we believe that we have both basically the business practices, the guidance and the personnel to provide implementation and pre-open at time of startup. And on a monthly basis thereafter with things like business best practices, we have a suite of vendors and suppliers of equipment that can provide the equipment very seamlessly.
Hal Hargrave (05:07.204)
You know, we look at tenant improvement scope to see how we might orient a facility with whatever space we are allotted to best fit the most appropriate equipment. And so whether or not, you know, certain equipment is needed might be up to the discretion of the agreement that is made with that particular health club or that person. Or we look at the geographics in the area and we ask ourselves what are the most important needs that we must have in this particular orientation of this type of facility to meet
kind of the demographic needs of the clientele that exist in that area. So there's negotiation there of what equipment is needed and what is not, but in terms of the other kind of business support options that we provide, really it's rooted in education. We have a proprietary educational model and certification program that we built in-house and a continued education unit model that goes along with that. So we provide requisite ongoing education to
members here at our flagship location and domestically as we expand to be able to continue to give them cutting edge information to be able to best practically treat their clients in a hands on form. We also provide business ongoing support, SEO, referrals, and of course the ongoing business measures to be able to ensure success through our 120 hours of hands on experience of best practice in the field over our past 17 years as a company.
Brendan Aylward (06:35.311)
Sounds like you've said that once or twice before. I definitely want to touch on the certification in a lot of detail, but one thing before we get there.
I think one thing that holds some fitness professionals back from including more people with disabilities is this idea that they need to drastically overhaul their facility or that they need very expensive adaptive equipment to do so. Would you, speaking from someone with experience as that adaptive athlete as well as a business owner, do you think just a traditional fitness facility could begin to more effectively support individuals with disabilities without having to retrofit?
fit their entire equipment.
Hal Hargrave (07:17.611)
not to be easily confirming or cliche, but...
The most important piece of the puzzle is the people, not the equipment. And we can find adaptability and suitability of existing equipment to provide really the platform for somebody to find equitable space within an existing health club, whether boutique or commercial. And we have the components through training and education to provide the inclusive programming aspect
Hal Hargrave (07:52.068)
in the form of equipment in existing space so you can bring diverse populations to your existing facility. It may not require any bit of a tenant improvement or an expansive overhaul of space or comprehensive equipment that can get you to the place where you can be operable for the paralysis community. Rather, you need to have an open mind with the set of team members that are willing and wanting to get trained in the paralysis recovery and rehabilitation
Brendan Aylward (07:58.479)
Yeah.
Hal Hargrave (08:21.968)
those best practices and innovative and creative minds to look at your existing space, your existing equipment, and provide the foundational components of our methodology and implement that directly into what you already have in your existing space.
Brendan Aylward (08:36.163)
Yeah, that confirms a lot of the stance that I kind of adopt, that oftentimes it's a lack of education and confidence in supporting people with different abilities than your traditional gym member. But like you said, the education that you provide can alleviate some of those concerns and kind of raise people's knowledge base to be able to support clients with disabilities in kind of unique ways with whatever equipment
Hal Hargrave (08:40.278)
it up.
Brendan Aylward (09:06.117)
have access to.
Hal Hargrave (09:07.462)
Certainly, and I don't want to call it ignorance, but a lot of people don't know what they don't know. And I think they've been told things and maybe have bought into that, that there's no hope for them to adopt something like an inclusive program like this because the money association with what's going to hinder the bottom line with such a vast setback and where they might incur the ROI. But quite honestly, the leap of faith is just taken in the mindset and perspective shift of one person raising their hand to say,
want to get trained, I want to take on this mantra of really being inclusive in terms of our programmatic options that we can provide to clients, creating equitable access beyond just widening doorways and having ramps that are built to code so we can have diverse populations. Because this real pandemic we've been facing is the diversity, equity and inclusion pandemic of the paralysis community that never seems to find a way to coexist amongst the able
sectors alike.
Brendan Aylward (10:09.719)
Yeah, so maybe going off of that topic, how do you envision that individuals in the paralysis community can kind of seamlessly coexist amongst their peers in a traditional gym environment? Kind of how do you define inclusion, I guess, in that regard?
Hal Hargrave (10:25.898)
Yeah, and I think there's many layers and many definitions to inclusion, if we're being honest. But as I kind of look at the broad scope of, you know, how the world is really trajectory today, you know, there's, and naturally speaking, we have a lot of these commercial health club change, your Bally's total fitness, your 24 hour fitness, I'm not telling them to redefine the business model to start placating towards a very small population in the paralysis community that only represents, you know, roughly five million people
so here in the United States, but what if they carved out mindfully, not even just, doesn't even have to be four walls, but a small space of their commercial setting, you know, a few thousand square feet, maybe less, to just say we have dedicated space here for inclusion. And I think what they would find would be this, and we've seen this case study done in real time here in Southern California. The Perfect Step was a part of a commercial health club called
This is a health club that was a private health club home to 10,000 members, 3,400 billable units of families and individuals at this health club. When we rolled in this particular program into this health club, we saw something literally change overnight in one year at this health club where when you talk about employee retention and membership attrition, we saw industry lows in that year happen at
where we fell from 23% down to 13 and a half percent of membership attrition on 3,400 billable units so you can see that's about what eight to nine percent So you can do the math we recouped about 300 billable units of members We assumed that was about a half a million dollars that we were able to recoup
in dues paying units and then another half a billion, a half a million in non dues revenue for other ancillary services that would have been purchased by those members. Requisitely speaking, our staff, we had 280 employees at this commercial health club, the Claremont club located about 35 miles east of Los Angeles. 280 employees.
Hal Hargrave (12:44.006)
Our retention rate of those employees in that year fell from 12.5% down to 8%. It was industry low in the commercial health club industry. So we started looking around, we're like, what's going on? So we go back to the members and back to the employees. We took a broad scale survey and we said.
Why all of a sudden are you choosing to stay? Because mind you, this was also a year for members that we converted to ACH payments, which for the older generation was like pulling their hair out. They were kind of old school minded thinking. So we figured that would run some people off. So members come back to the club.
you know, fill out the survey and they say, well, you've created a universal set of values that I feel like we're doing good for the community and you've created a cultural sense in here that feels as if like these are appropriated values I want to teach my kids about, about inclusion and you know, how they can live amongst people that are, you know, incurring setbacks but they're no different than us. They want to coexist with us.
Hal Hargrave (13:50.692)
why are you choosing to stay? Like we get that we're paying fair, but you know, usually we see a larger flux of people looking elsewhere for new job opportunities. Why'd you stay? And they said, well, you've created meaning and purpose behind what we do through inclusive programming that I feel like we're solving problems in the community rather than just talking about them. So the Claremont Club in this model, it made money by accident.
by addressing diversity, equity, and inclusion, by saying, you know what, we're gonna do more than just being ADA compliant, by putting in lifts, and putting in elevators and winding doorways. Rather, we're gonna provide inclusive programming. And it was more than just the perfect step as well. They created programming for people living with cancer and diabetes and Parkinson's disease for recycling for Parkinson's program. And it was these programs.
that literally changed the cultural landscape of this club and they made money by accident. So when you ask me, what does that look like in real time? I sense a vision of real diversity in our clubs where we live, walk and work out amongst each other. And there's opportunities for synergistic movement and cultural change amongst each other where there's a person in a chair that's incurring a physical setback that has reveration for the person that's able-bodied that's working out across the way from them.
and there's a sense of hope and motivation by the person that's already able-bodied looking at the person in the chair saying, I need to be on it. I need to be honoring what I already have. So, as a collective, we come together and we create the change we want to see in the world.
Brendan Aylward (15:30.223)
Yeah, a lot of good things there. I've been writing about the value proposition of inclusion because I think a lot of times people associate it with charity, they associate it with fiscal sacrifice in place of that purpose, but the two...
The two aren't mutually exclusive. We found, at least in our facility in Massachusetts, that a large percentage of our revenue comes from our adaptive athletes. And then we create a cause that the rest of our membership really cares about. And they feel like their membership is supporting something beyond just themselves. So when you go through those periods like COVID, when everyone's getting rid of their gym membership and working out at home, our clients continued to support our business
for our community and I think one of the best ways to kind of normalize inclusion and disability is through shared recreation. So like you said, that individual in a wheelchair is seeing the able-bodied person training alongside them and they're looking up to them and vice versa. That able-bodied individual is grateful for the opportunities that they have and maybe it pushes them to work harder and appreciate that more. So the value proposition of inclusion is huge and I love that you guys are a for-profit entity because one, it confirms my biases
reserved just for charities. But two, it's just showcasing that gyms, you don't have to do it as a service of goodwill. You can do it as an aspect of good business. Yeah.
Hal Hargrave (16:56.722)
Love that, Brendan, and I think to the for-profit, nonprofit comparative.
I actually have and I run and operate and founded a not for profit entity called the Be Perfect Foundation 17 years ago. Kind of at a co-conclusive timeline to that of when the perfect step embarked as well. And the Be Perfect Foundation is a 501c3 not for profit organization that raises funds for the paralysis community for fundamental needs, wheelchairs, medical supplies, home and car adaptations, participation in an exercise based therapy program.
We're a not-for-profit that doesn't have paid staff, 99.9% of every dollar, goes directly back to program servicing, to serving those in need. And we've raised over $9 million over the past 17 years because we identified that the for-profit side was solving the inclusive programming, but the affordable access to fundamental needs still was not met with what insurance companies would reimburse for.
We've kind of cotandomly built a two-headed monster not to be self-serving. Our reach for the Be Perfect Foundation is very domestic, not just regional. And we ensure that there is not a pass through there just to the perfect step. A lot of our program services are completely far and away from the perfect step to individuals that have fundamental medical and health needs that are living with varying forms of paralysis. So you know, you brought up, you know, is inclusion only helpful?
for the not-for-profit sectors. In that case it is, but it's not mutually exclusive to that either.
Brendan Aylward (18:39.351)
Yeah, absolutely. And we operate AdaptX as a nonprofit for other reasons, non-monetary driven, but then our gym operates as a for-profit. I was going to ask.
The, as a for-profit entity, you're often serving individuals who, post-injury, might lose employment opportunities, might have socioeconomic situations where they need some financial support. So how do you balance that, like, charging what the personal trainer is worth, but also creating and offering an accessible price point for individuals who are already facing,
and economic challenges.
Hal Hargrave (19:23.786)
Yeah, that is kind of the golden question when you talk about a for-profit model and a feed-for-service model with
you know, obviously clients that are already facing financial hardships and do part to their setback of their injury and diagnosis. So we've actually approached this in a kind of a multifaceted way. When we were at the Claremont club and I say past tense because we are now in a different location, the pandemic unfortunately kind of derailed the Claremont clubs 47 year history because of LA County guidelines that forced them to
rebound. But when we were there, if you want to talk about real inclusion, the club was hiring individuals with disability oriented backgrounds and they found positions for them that were workably advantageous, whether it was working with the kids in child care and reading to them or working at the front desk or working desk jobs or if they were semi
Maybe it was working in the laundry room or things that you didn't necessarily need to be an able body to facilitate, but the club would provide employment to them to help offset some of these costs that were associated with therapies. And so the other approach that we take is we have a client success team here at the Perfect Step where we sit down with every client in our program at time of start in our program and we talk about financial planning. We talk about fundraising.
efforts and we give them blueprints and models on how to fundraise and how to implement these financial planning strategies so they can find longevity in our program. We talk to them about grant writing. We talk about them seeking foundations for foundational help and so all of those things tend to move people along the recovery timeline just a little bit longer to stay in our program for greater consistency and longer periods of time than otherwise they would
Hal Hargrave (21:32.12)
be vastly set back in their health measures because there's not financial sustainability in a program like this where there's no reimbursable cause for care.
Brendan Aylward (21:42.075)
Yeah, that's a really interesting point to kind of have that holistic support where you're not necessarily...
funding their training, but you're pointing them in direction of resources that could potentially do so. Let's talk about the actual nuts and bolts of the perfect step and the training philosophy that accompanies it. So you guys created the STEP, Certified Paralysis Recovery Specialist Program. Can you talk to me a little bit about how that evolved, whether it was something that you had from the get-go or whether it was something that was kind of built in tandem as you started providing services?
Thank you for watching.
Hal Hargrave (22:20.766)
So the perfect step was previously known as a Project Walk franchise facility. So Project Walk was an inclusive program option in the chronic stage of recovery that at its peak had 18 worldwide locations. We were actually in terms of geographics their closest location to their flagship facility.
of San Diego and Southern California, us being in the Inland Empire, greater Los Angeles area. So we had for a few years the educational dialect of being able to be educated by Project Walk and unfortunately they closed their doors and we were forced to go through an intellectual property rebrand.
Hal Hargrave (23:14.128)
any mutual exclusivity to Project Walk any longer, and their proprietary information was theirs, so we kind of had to go back to the drawing board to ask ourselves, what are we gonna do through this rebrand to reestablish continued education, and to rebuild the certification program under our new vocabulary dialects, under our new acronyms and what have you, of what we believe in terms of best practice.
the most effective methodological training approaches should be practically implemented. So it was kind of twofold. Number one, we reestablished what our methodology and approaches towards recovery. And we came up with three key components to a methodology that we believe are the most effective means to treat individuals with neurological disorders. First off is the incorporation of safe and appropriated exercise and to apply exercise as a form of medical.
to clients that are vastly limited due to the assistive device of the wheelchair, of the Loftran crutches, of the walker, of the AFO, KFO. Those were all intended to be devices that provide stability. So when our clients come into our building, we rid them of
those particular apparatuses because the body is going to ultimately conform to the environment that it's most susceptible to. So we wanna create an environment that is very much true to able-bodiedism. And so if we reduce the susceptibility to these assistive devices, we can get the body to heal more in an orientation that's very true to able-bodied life. And we have expert help in how to train, how to spot, and how to create a safe environment in here. So we try to get the body to heal away
from the assistive device and incorporate exercise in an approach of training posturally correct first and anatomics first, and through biomechanical efficient movements first to induce appropriated healing. The second component is load bearing. It's widely known that people that aren't up and ambulating as much as that of the able-bodied population, and very similarly to that to the geriatric population, who see a vast reduction in their bone
Hal Hargrave (25:36.416)
health when they get to a particular age. That is very similar to our clients who sit for maybe 13, 14, 15, 16 hours a day and you start to see a lot of those body systems start to slow down. Indocrine system, various body systems that might be contributive to that of producing calcium and osteocalcin to particular parts of the bodies that help ensure the integrity of bone structure.
And so when we put them into a load bearing environment, not passive by just standing, but more active load bearing through ambulation over a treadmill or ambulation over a robotic gait training system, or getting vertical and doing jumps into a total gym or various apparatuses that we have standing on a power plate, we can actually try to reduce the effects of osteopenia and osteoporosis by promoting appropriated bone health to restart and re-
to start those body systems again, to start producing those biological things, to get the body back to an appropriated restoration of health. We know clients are going to pursue ulterior interventions of reclassed infusions that can ensure bone health or calcium supplements which aren't really reaching the bloodstream as much as we hope. So if we can provide more neuromuscular reeducation onto the body to ensure better musculoskeletal health, that's going to put the client in a better place to live healthier.
And then last component is our approach towards reactivation and reorganization of the central nervous system. We call this pattern neural activity recruitment, known as an acronym of PNAR, and that is a registered trademark term through the US government that we got backed with a lot of our other intellectual property. And really this is our approach and our foundational teachings of how we provide input back to the body
out of the body that we're looking for. So a lot of people are looking at this terms of afferent and efferent signaling in terms of input and output into the body. So our understanding of the neurologically compromised is that their interpretation of input into the body of sensory and proprioceptive stimuli is very inhibited.
Hal Hargrave (27:59.366)
and very altered. So our specialists have become very keen experts to know through a multitude of factors how they can provide the appropriate stimulus back into the body through a closed chain environment and with resistance bearing input into the body to give the body the appropriate amount of sensory and proprioceptive information. And they do this through an alteration of hand placement, speed of movement, angle of movement, positional
induced movement and in real time to the naked eye this would look like stretching but we take everything that we do when appropriate and we take it from passive to active so what would that mean passive would be passive stretching would just be deep breathing and breathing through to get more appropriated ranges of motion and length through particular extensions of muscle groups where we try to actively engage the client central nervous system
to recoup motor function output from the body.
to be able to create controlled invalidional movement over time. So we're taking an active approach as opposed to passive. So what we find is if we can induce this with precision, with repetitiveness, over and over again the hope is to achieve neuroplasticity to create neuroplastic change and to create a new neural pathway so somebody can have more controlled invalidional function again. We know that in the able-bodied population to achieve neuroplastic change you need 400
repetitions of a particular movement to see that through. We understand that really compounds with the neurological effects of the clients that we treat. So we've got to be treating people over and over again and with repetitive precision to get to that point. So that covers the methodology side of things. When we talk about what we've created in terms of educational programming, we've built a four tiered structured certification program starting with our entry level,
Hal Hargrave (30:03.016)
certification which has prerequisite requirements of educational schooling, background and what have you. And then there's a 150 hour plus educational program that we put somebody through that's conclusive of hands-on experience, shadowing, book work, test taking, lectures, seminars, educational work with clients together, real world experience, projects, before somebody can even work with a client hands-on.
And then they get this entry level certification. They work with client.
And then level two is the next step up the ladder, which you have to incur a certain amount of hands-on hours. Other prerequisite requirements, essay writing, programmatic development. And then there's a level three certification, again, more prerequisite requirements. And then our top level and top tier certification is what's called our educator. And that is a person who is then qualified to train new people that...
they comprehensively understand our methodology so much that they can redeliver that education in a format where it can be taught and learned. So again, this is all conclusive of particular book works, lecture seminars, test taking. We have about 700 pages worth of training and operating manuals that have been copyrighted as well. And we've built out a digital learning management system and we have a learning management platform where we can train people educationally across the country.
and it also is a multi-tiered digital platform where it also has a digital training component to be able to also train clients in remote areas across the country and world as well too.
Brendan Aylward (31:46.199)
A lot done back there. Did you conduct any sort of like Delphi or expert review of the curriculum? Did you collaborate with anyone outside of Perfect Step when you were building these educational materials?
Hal Hargrave (32:02.154)
Yeah, so we've kind of had the broad scale influence of.
Some of our healthcare professionals that are in the field, we have a team of a board of directors of different team of doctors and physiatrists as well as general practitioners who kind of have provided facility and educational oversight to us. We have had some co-collaborative efforts with local rehabilitation hospitals and the integration more recently with their licensed skilled
Hal Hargrave (32:37.128)
to find appropriateness in what we do, but much of our educational formatting and materials in terms of the written content is completely site and sourced from educational journals to really kind of provide backing through what we're doing. And we also have a research division to what we're doing here at the Perfect Step. We have four concurring projects right now of data collection that are going on in-house.
of a massive internal overhaul right now of taking all of our written assessments from the past and our evaluations and backdating them and putting them into a digital platform where we can get everything digitized so we'll be able to do research projects on the fly to be able to gather the data that validates our effectiveness. But I'll give you a past research project that actually just got submitted to journal actually just two weeks ago.
a particular research project that was done in co-tandem with Kaiser Permanente and their regional hospital of Fontana here in Southern California. And their lead doctor over there, his name is Dr. Robert Salas or Bob Salas, and he's also the lead doctor of the National Exercises Medicine Initiative, where he's trying to get governmental reform to ask doctors to be able to prescribe medic exercise as a
form of medication that is reimbursable by insurance company rather than just medication itself. And this doctor has used our particular location as his beta site to show validation of success.
that programs like ours actually do increase quality of life and reduce secondary health complications that could result in rehospitalization. He saw this with his own two eyes, but he said, you know what? Kaiser Permanente needs to do co-tandemly a research project on this to show through data that this is true. So we did a multi-year study with Kaiser Permanente.
Hal Hargrave (34:41.906)
assessing increased quality of life in our clients and a reduction of secondary health complications, bladder infections, pressure sores, independence levels, heterotrophic
Hal Hargrave (34:56.03)
I guess you could say emotional contentment. And we looked at these different measures. We had 92 different questions that we asked on a Likert scale on a survey over a multi-year study. The way it was segmented were these questions were asked prior to somebody coming in our program, six months after being in our program, one year after being in our program, and two years after being in our program, to show a barometer of change over time with how our program has influenced quality of life.
and secondary health complications. So we got the outcomes of the study.
91 of our 92 measures came back with a p-score value, 0.05 or greater indicating significance that we're increasing quality of life and reducing secondary health complications. And this is groundbreaking when you think about the chronic care continuums and exercise-oriented facilities that have a mindset around activity-based therapy protocols that we're really doing things beyond the traditional model of care. Once insurance runs out as a viable continuum to care, that if you're an insurance company,
should be salivating looking at this thinking like, wait, there's an inclusive program option out there that can keep our clients healthy and off of our dime of a large hospital bill racked up because they're deteriorating. And you know, what's reimbursable? I don't know, maybe it's 10, $15,000 a year that they're willing to throw in the hat to say, use this as you want for whatever care that you like. And then for clients, it's like, okay, I only have to supplement and offset the difference of that
or make lifestyle changes to stay sustainable, an activity-based therapy program over the years to stay healthy. And so we feel as if some of these data representations in these research initiatives are really leading to a place that's going to prove to the world, programmatically speaking, we've got to have access to these types of programs in major regions across the country so clients have access to be able to live a healthy life again.
Brendan Aylward (36:59.527)
Absolutely. I think SALIS is on a lot of the barriers and facilitators to physical activity for individuals with disabilities research that I've read. How can that model that you guys implement be adopted in traditional PT? And if the outcomes are superior, why has it not been?
Hal Hargrave (37:21.07)
Um, you know, I have an immense respect for the licensed skilled therapist. So for me, there's not really a naysayership around what they're doing or what they shouldn't be doing. I think where they exist in the continuum of care, they really provide an approach that prepares people for life transition back to home.
they give them the requisite knowledge, skills, education, and techniques to be able to occupationally adapt to activities of daily living that are probably much more needed at that moment in somebody's recovery trajectory than what we offer in terms of intense activity and exercise. And so I understand where they're coming from. The traditional model of care has to adhere to a billable units model of care.
where they have to show particular...
beneficial quantitative measures of increase in KPIs that show progress. And so their approach much of the time is to focus on the areas of the body that already have instilled function because then it becomes really a strength training program of what volition is already there. And you're really compounding on that. We really take the approach adversely to work from the ground up as opposed to the top down. Also, I mean, you could throw a central cord
injuries out of the way when they heal differently. But we focus on the areas of the body that don't have instilled function and we try to reactivate and reorganize the central nervous system there. And I won't say first because there is kind of a balance of symmetry where we work on both, but we're not just acknowledging the areas of the body that already have instilled function and we're not going to just work on slideboard transfer and technique 100 times over again. Do we find valuability in that? Yes. But we look at the other
Hal Hargrave (39:14.736)
intrinsic parts of the body that are required to be able maybe to facilitate that activity of daily living. Okay if somebody wants to slide board we don't just need to work on technique what else is needed okay we need to work on shoulder stabilization and shoulder girdles, extension at the triceps, better stability through the core muscling so we can get more on top of the hips to relieve the issues of all the load that they're receiving. Is the client able to take any of the load down and in through the feet?
kind of a lot a lighter mass to slide across the board. So we're going to work on all of those things from that perspective more holistically. So in terms of the adoption from the traditionalized community to take this on, I don't see it happening. I don't expect it to happen. I think that's why both containers of care can and should coexist. Both have valuability. I believe both have proven
KPI's that matter. I just personally tend to think that in the chronic long-term stage of recovery, we need to get to these optimal stages of KPI indicators of health measures that keep people out of the hospital. That's the last thing that a person in the long stage of recovery wants to find themselves back in again.
Brendan Aylward (40:35.683)
Yeah, it's also like it doesn't necessarily have to be implemented within the therapeutic setting, right? Like the recovery process, whether you, as you refer to a chronic stage where there might really be no end point of recovery, but there has to be a transition from.
initial rehabilitation to reintegration within your community, right? And traditional gyms can provide that if their staff have the knowledge base and the willingness to do so. So I think, and I don't mean to imply that or recommend a path forward, but like your model doesn't have to go to the hospital. It doesn't have to go to the physical therapy clinic. It can be that next step towards an individual's recovery process.
Hal Hargrave (41:22.25)
I think you more eloquently said that than I probably could have formed in my long-windedness, but I think that's a very appropriate thought.
Brendan Aylward (41:26.964)
It's...
Yeah, yeah. Are there some levels of SCI that respond more favorably than others to this model of training?
Hal Hargrave (41:38.922)
You know, I think where we really are challenged is the lower motor neuron injuries. People that really have a disdain function in their lower extremities because of such a severe injury where there's no apparent...
you know, spasticity or tone, there's no apparent response to even deep functional electrical stimulation pulse. Um, that creates real challenges for us to get neurologically a signal to particular parts of the body to activate a controlled and volitional or even non-volitional contraction to get muscle integration in the muscle belly that can promote musculature, that can promote continued sensation. Um, so that is
still something that those severe injuries we become very challenged with. They still have other therapeutic properties that can be approached and influenced in terms of the load-bearing aspects, in terms of the other holistic aspects, but where we find real bread and butter in what we do, I would say people that really have gotten to a place of being able to have some functionality to
Hal Hargrave (42:57.9)
groups, if not isolated movements in the lower extremities. And I think that goes without saying anybody would say, oh, you're saying that people who are already walking already have movement, you can get walking like voila, like what a big deal that is. No, I think there's some repetitiveness to that we can take somebody who's even on the brink to that point, and maybe people who are already gate training, it's not enough for us to just look at and say, oh, they're gate training, that's great. How do we refine the gate pattern? What is the swing phase?
fight like with perception, what does heel off look like and toe off look like with actual precision, you know, and really breaking down the gait pattern to not just say, oh, it's just enough that you toe drag. How do we create appropriated mechanics to that? But when we look at cervical level spinal cord injuries in particular, they tend to present with a lot of opportunities for healing, mainly because they also have opportunities in upper body for healing for muscle.
for stability-based work, for reorientation of reactivation and reorganization of the central nervous system. They need functionality work, they need coordination work, balance and stability work, not just in lower extremities but through the mid part and through the core.
So there's a lot of varying approaches we can take with cervical level spinal cord injuries that really adds to kind of the complexities of what we provide. And we find that a lot of our cervical level injuries really are highly motivated because they don't have their upper body or their lower body working for them, so to speak, at the capacity that would be really advantageous to living a very independent life. So they're highly motivated to work on the entire body
of optimal health. And this isn't really a nayshares ship towards thoracic or lumbar level injuries to say they're unmotivated, but we have found sometimes there's a little bit more contentment that they are already living very feasibly a life that is very fluid in terms of living on their own, that sometimes their orientation of what they want out of their recovery might be different than just focusing on lower extremity leg work. But
Hal Hargrave (45:16.134)
I think our program and our methodology can lend itself to be beneficial.
to a lot of different people and it's not just a promise of saying, hey, if you come here and you work out, we'll get you back controlled and volitional movement. These are things that we can't promise. What we can promise is that if you stay consistent with this and committed to this over time, you will become a healthier individual of yourself. A lot of things that we might see in our clients that really matter to us the most are they lose weight.
They become more functional in activities of daily living because they become more stable and a lot stronger to be able to reach, grab, manipulate things. We see more than anything the self-identity complex change. People become more confident beings, comfortable in their skin. They want to get back out and integrate with society and people again.
They find the wherewithal to say amid my circumstances, I'm gonna go live again. And living's a verb, it's an action, but it's an action that starts in the mind. And for us, when we see that outside of our four walls, that is almost sweeter and a better response to recovery than physical recovery itself.
because the likelihood of somebody getting back to that picturesque life of living life fluidly as they knew it physically with perfect ambulation the opportunity to do all the things they once did probably isn't a sense of realism but just because life is different and the how you do things is different doesn't mean it can't be better.
Hal Hargrave (47:06.378)
And it's the lens that you're looking through and the mindset that you take with that to live under your new circumstances that will set you free. And for our clients coming into our four walls, finding community, finding a network, finding people they trust to facilitate our methodological practices onto them, that is what they need more than anything on a social level.
to heal spiritually, mentally, and emotionally before they even do physically. We know that the body's physical state of healing starts with healing in the mind first. So if we can start with healing here, the body's an instrument of the mind, likely the body will follow.
Brendan Aylward (47:48.611)
Yeah, you mentioned that living looks different for everyone and in these different stages of life and people with varying injuries have varying degrees of motivation and goals. How do you balance that desire to be more able-bodied versus be content with your current state? Like you don't want to.
diminish someone's goals to walk again, but do you have those conversations with them where you say, yeah, maybe that's not the best use of your time, maybe we should work on other aspects that make you more quote unquote functional in your new form of ADLs.
Hal Hargrave (48:30.266)
I think we need to really insinuate a better understanding from an emotional level, somebody's attachment to contentment and complacency. Because they're very different. We're not asking our clients to find complacency with, hey, you may never walk again.
but we are asking them to find acceptance and contentment in the fact that even if you don't, it doesn't mean you failed. Like the barometer, so to speak, of success around, if somebody's recovered with optimal success is dictated of, oh, well, that person's walking, so they must've really busted their tail. They must've really worked hard to get back up on their feet. And...
They deserve an award show and we should just honor them. And all these people that didn't walk, try a little harder next time buddy. You must not have done the things the right way or the right things. I'm also not trying to discredit or diminish the walking people that have walked away from this. They should be celebrated. They should be applauded. And I do know this, if you do nothing, nothing will happen.
But there is some extraneous circumstances that for the things that are out of our control, sometimes walking because of the severity of your injury might not be in the cards until an ulterior intervention of technologies that are coming to the forefront now, that are intervening on your life, might be needed as a supplement to get you there. But in the meantime, if you are going to find
complete complacency in this idea that if I just do nothing, I can just wait around for these interventions to come or a cure to come and I'll be able to just act on that. That's not how it works either. Like you've gotta be doing something between the here and now and then.
Hal Hargrave (50:30.134)
to prepare your body to even be a candidate that can raise your hands that says, hey, I'm an approved candidate because my blood pressure's intact because I've relieved myself of the tet hose and the stockings because I've practiced my pulmonary system and my circulatory system by constantly being in a state of motion. I've challenged my bone density to increase it by not only taking supplements and doing reclassed infusion,
and taking calcium supplements, but I've re-jump started my biological processes of my body systems by putting musculoskeletal load onto my body by being in an active load bearing environment. I've challenged my bone health. I've challenged the limber state of my body through ranges of motion and through active orientations of exercise-based therapy and an activity-based therapy approach that has prepared me to be a candidate for what's to come next.
contagious things along the way, but let's not get remissed at the idea that of course for all of us that are catastrophically set back, the holy grail in the end all be all is to walk again. Of course. I mean, we all want to live the abled life that we once knew or for some people that they never knew. But that doesn't define who you are as much as
your ability to take whatever hand you're dealt and play those cards the best that you can. And I think we think that the hand we're dealt dictates who we are, where really what dictates who we are is how well we play that hand. So for some, living is only defined whether you're walking or not. And others, they see the writing on the wall that they can live amid the circumstances.
they can find comfortability in their skin, that they can still be a world-class athlete that maybe does it from a chair, that maybe they can be a business entrepreneur, that they can still be a father, that they can still be a best friend, that they can still be anything they want to be. The mode of doing things is different, but what they do doesn't have to be. And the value orientation is still there. And I tell people all the time, they're like,
Hal Hargrave (52:53.43)
I just, I miss walking again. And I'm like, I understand to a degree, but I'm like, let me ask you something. The things that you did that you miss in your life, the memories that you hold, maybe it was a trip, your association with that memory of what you miss, when you close your eyes and you think of that image of that memory.
Does your mind really go to first you walking in that moment? No, usually it's what you see outside of you. Maybe it was a mountain landscape. Maybe it was a historical monument. Maybe it was the people. Maybe it was the internal feeling that you felt in that moment. And I said, so maybe you need to get back to seeking again. The feeling.
associated with whatever that moment was and not the act of what it was. Because we can duplicate those feelings in different ways. If you told me that, oh, I felt freedom with walking, you can feel freedom in adapted skiing. You can feel freedom in travel. You can feel freedom in getting back behind the wheel again. Like I can show you how to find freedom again. Oh, I felt X.
I can show you how to feel excitement again. Like, we can duplicate those feelings. So maybe the real attachment is to the feelings and not to the legs. We've got to change our lens on what we really are longing for again.
Brendan Aylward (54:35.159)
You mentioned one portion of your methodology is to remove the assistive tech that an individual uses. Has there been any resistance to that? Like does this idea of trying to make someone more quote unquote able-bodied get met with any resistance? Like it's diminishing their new situation and it's like, is it ableist in any way to assume that they have to move towards this?
this new form of movement.
Hal Hargrave (55:05.694)
Yeah, I think this is an important moment for me to clarify.
We are very pro technology, no question about it. I mean, I don't mean to name drop, we have a cutting edge piece of virtual reality equipment in here that we just partnered with the company that I've signed an NDA. I can't speak on the company's name, but they're bringing it to market and they're conducting clinical trials here right now. We have a geo system in here with a robotic gate training. We have five functional electrical stimulation device through RTI. We have an overground walking,
Medica, we have track systems. Like we believe in those ulterior supplemental technological interventions. We actually have built out a holistic recovery room with all these broad scale technological interventions as well to supplement what we do in the form of cryotherapy, hyperbaric chamber, infrared sonar, water massage therapy, Beamer technology, Nano-V technology, we are pro technology. However, we do believe that your opportunities to use those assistive devices
you're gonna use around the clock once you leave the building because they provide a safety measure to your life that we also believe in too. Like we don't want you to leave here and say hey go walk recklessly without your AFO and KFO roll an ankle you know have a you know a non-stable hip fall hurt yourself that's not the goal.
But while you're in here, you have an hour or two hours time with supplemental expert help that if you had an AFO on, it's providing stability to the ankle region. Your ankle doesn't planar adorcephalic as effectively with that on. Laterally speaking, the ankle can't get to circumduction, inversion, eversion. It's stabilized. So in here, if we take that off.
Hal Hargrave (56:57.858)
we can work on getting to better ranges of load in the gastroc.
or really challenging the tibialis anterior, applying functional electrical stimulation technology to those areas unless you have a lower motor neuron injury and you're not really responding to that. So we can influence those really intrinsic muscle groups to get them to fire again, because otherwise, if you just have that stability there the whole time, they're gonna sit idle. I mean, look at a wheelchair and what it provides in the form of a 14-inch backrest, in my case, a contoured ergo seat that provides a deep butt.
for me to be further stabilized in a platform for my feet. Like I'm really not challenged, but a little bit through my core and the innervation of my core muscles to sit here, you know, with balance and stability because the chair is doing that for me. So if we take them out of the wheelchair and we train in a posturally correct state and we work on, okay, to sit in a wheelchair more effectively to get to better posture, we've got to work on rhomboid contraction, scapular contraction and decompression.
We got to work on, you know, not just shrugging shoulders, but getting to a state of depression to get the better postural pedics. How do we get to a place where we get better rotational movement so we can work through the three planes of motion that are often inhibited through a wheelchair and we have expert help and sufficient spotting to provide safety measures while clients in here. And then as we evaluate where somebody's at in the recovery continuum and in an appropriated
look at that and say, okay, now let's apply the technological supplemental advances that can really help and supplement what a client needs now to succeed with what we can't do as specialists. So those times do come. Hey, Brendan, really quick, can I pause for just a quick, quick second? Sorry, I have a staff member that needs to grab this. Nathan.
Brendan Aylward (58:51.543)
If the... Yeah. Yeah, of course.
Brendan Aylward (59:02.339)
Also, do you have a hard time you have to be done by? Okay.
Hal Hargrave (59:21.298)
Okay, I'm back. Sorry, I had to give an iPad and a flash drive to staff. Speaking calm. Great.
Brendan Aylward (59:26.147)
No, you're good. No, man, I'm blown away so far. Yeah. All right, let's dive back in here. So if someone is interested in these topics or they peek someone's curiosity, what background do they need and how could they go about learning from the perfect step?
Hal Hargrave (59:45.73)
Great, yeah, so for our specialist position, and I'd say that is maybe the most sought after position to be able to have the one-on-one working experience with our clients, we require a four year degree in something relating to the human body. Exercise physiology, exercise science, kinesiology, movement, sports science.
you know, even human biology are kind of appropriated. At that point, we can provide the ongoing education to get them appropriately trained. But I would say beyond the educational background, we care more about an individual's passion and purpose for what we do. Like their writing is on the wall in an interview process with somebody of, are they here? From a transactional sense that this is a job for them? Or are they here because they want this to be a career? And we don't mean that so much
literal see as much as we do figuratively. If we want somebody to be in the mindset that we don't want you to think about this in terms of the short term, we want a long-term commitment because the sustainability of our program and how our program has been built has been off of the creed that we've had a group of individuals that have found continued benefit in upping the ante of their practicality of their work through their past experiences. Like that is what's made an all-star team here at our flagship location.
of individuals that have well over 8,000 hours. We have an individual that has over 16,000 hours of experience in this field. And as a collective right now, our current staff over 70,000 hours of experience. And as a collective over the history of our company, over 120,000 hours of experience. All of that information continues to get refunded back and to hear of a sharing of best practices. And we're constantly looking for individuals that are cutting edge,
but people that are fueled by passion and purpose before they earn money, the money will come as a byproduct of this. Like you should get paid for what you do well. You know, we completely understand that too, but lead with passion and purpose to make a difference and the rest will fall into place.
Brendan Aylward (01:01:56.171)
Absolutely. But what if someone's in, for example, Massachusetts, they aren't near a perfect step. They don't have any prospective clients with an SEI or with CP or post-stroke. How can they get started?
Hal Hargrave (01:02:12.554)
Yeah, I would say the perfect step doesn't have to be the end all be all. There's other great agencies out there that do offer opportunities for continued education and learning.
You know, there's a couple different firms out of Florida that will offer this. You know, your local rehab hospitals, but let's just say this is perfect step specific. We actually offer virtual training programs to people in remote parts of the country or the world where we can train them in a remote sense or we even offer a hybrid option. You can fly in for a week or two at a time. We would train you and then you would take that information home and we'd have follow-up supplemental training.
the diversity of needs that are met in terms of your educational needs to be able to take that and then apply that to the populations that we identify this is applicable towards. So there is a multitude of options that we can make work. We don't intend to hoard education, nor do we intend to think that we believe we're the one-stop shop for education. I mean, my gosh, we know this much about this much in the world. We can also be learning from the life.
licensed skilled therapists, from the doctors, from the educators, from the practitioners, from the journalists, from the researchers. We've all got to come together at some point and say, egos aside, I don't need to be the guy holding the golden egg. But how do we all come together to share in best practice to then take that information and give it directly back to the clients who are the most important people in this equation so they have a betterment in their life? So ask yourself passion and purpose first. And if the perfect step fits your mold.
We have those options for education for you. You can even start by tuning into podcasts like this. You're gonna have opportunities to learn from great medical professionals, organizations, businesses that are trying to find their way. The Perfect Step has their own podcast, not to be co-competitive, it's called Pathways to Healing, where we have medical professionals and fitness professionals on our podcast to share an education about their experience.
Hal Hargrave (01:04:26.156)
as well as clients who share client stories. And maybe your best form of education that you can go seek is directly through the clients themselves. If you want to practice real inclusion, go talk to them. Share and story with them. Ask them about their experiences. Ask them about the best practices that were most effective getting them closer to the life that they want to live. And maybe that will give you an idea of where to start.
Brendan Aylward (01:04:34.553)
Yeah, absolutely.
Brendan Aylward (01:04:52.183)
Yeah, for sure. And we'll link your show in the show notes as well for people to check out. This has been highly technical, certainly applicable in many cases, but maybe to pare it down in the most rudimentary sense. So if you were to roll into my gym...
You had no training background. You obviously didn't have the knowledge that you have, the highly technical knowledge that you have. What would you want me to do as your trainer? What would you want me to ask you? How would you want that first session to go? What are just like the basic recommendations that you could have for maybe an aspiring fitness professional or a current personal trainer that's not working with individuals with SEI?
Hal Hargrave (01:05:37.066)
I would start with a comprehensive or maybe less than comprehensive assessment of abilities within the body and be keen about language as a practitioner. Know that maybe not offensive language is the right word, but language that doesn't supplement that to motivation and excitement.
when you take a keen focus on what somebody can't do, that creates immediate challenges of rapport building and trust with them, that that's where your focus is rather than the focus being on what they can do and building off of that to create more ability in their function. So when we look at that requisite in real time, look at somebody's abilities, also ask them what are their SMART goals, specific, measurable, attainable, realistic, and under what timeframes?
and frame that up. Frame that up also with your recommendations for them from your perspective. Look at their body very holistically. If somebody's in a chair, conduct a visual assessment of them when they come in. And this can be done. Here's a couple of examples. How are, what's their posture like? How are they sitting? Do they look comfortable? What's their body language?
Are their arms crossed? And if they are, is it because they're fixed? Or is it because that's a position of a defense mechanism? Let's start looking at the psychological responses to this because we know that when we have somebody's attention and they're receptive, their arms are typically open or at their side, they're not closed off. So how are they presenting in terms of body language?
Is the body language representative of that of a psychological emotional response? Or is it representative of that of a physiological response where maybe the body's under conformity? They're slouched one way. They're hunched over. They have bad posture. How are their feet sitting on their chair? Are their feet kicked off their chair? That would be indicative of tone or spasticity. Do they have plantar flexion at the ankles where the ankle is not sitting flat on the toe plate? How are their legs recessed?
Hal Hargrave (01:07:42.326)
back underneath them or farther forward on the toe plate, it might tell you about the length that they have in their hamstring and behind the knee. There is so many different visual cues that you can pick up on, just from somebody in a chair that can tell you where to start. Somebody walks in a walker, assess their gait. Are they loading too much through their shoulders? Are they properly postured where maybe...
the walker is just supplemental and not fundamental. And start to use your fitness mind and background from there. If you're already oriented around fitness, you know, posturepedic, you know, anatomics, you know, physiology, you know, biomechanics, apply those same things and then supplemental education for the neurological side of it can come in due time.
Think about how you would want to be trained, how you would want to be rehabilitated. Put yourself positionally into the modalities and the exercises that you are the clients. Try to feel what they feel, try to interpret what they interpret. Have somebody else be the third body that is applying that, or the second body that's applying that input back into the sensory and proprioceptive input, the load bearing, resistance bearing input in a closed chain environment. Should you train them closed chain?
focusing on functionality? Or should you train open chain to focus on muscles? What is the body calling for? Use your logic, don't overthink it, but start with the visual cues first. Ask the deepening questions to gain the assessment. Gather the information around fundamental needs, wants, desires, goals, and work forward.
Brendan Aylward (01:09:35.195)
What are the contraindications that someone should be aware of? Can a trainer do more harm than good?
Hal Hargrave (01:09:41.79)
I would say contraindications to be wary of.
are definitely, and we have this as a prerequisite requirement here, is bone density affluency. So is somebody in an osteoporotic state where it really would be detrimental for you to load-bear intensely with them or manipulate them in a particular way? Do they have dislocated hips? Where do they have heterotrophic ossification at what joints? Do they have a shortening in particular muscle groups that don't allow for full range that if you were just to crank them to full range?
rip, you know, some sort of legament or muscle. Where does sensation stop? So you can really be mindful of what type of pressures you're applying to the body to not make the body susceptible to pressure sores through rubbing and deterioration of skin. You know, is somebody a woman pregnant that would maybe differentiate of what types of pressures you put on the abdominal regions?
Does somebody have setbacks with blood pressure? Because would they be more likely to pass out? Is somebody a diabetic? Do they need to have proper nutrition, which that would be the case for anybody, by the way. Your water intake and your food intake pre-workout to be able to be supplementally in a place where you are conducive towards high intensity, unorthodox approaches towards working out.
But I would just say use your logic. If you were in a debilitated state and vastly hurt, how wouldn't you want to be moved and manipulated?
Hal Hargrave (01:11:16.118)
But you gotta be asking the appropriate questions because likely you're gonna have to be a greater advocate for a client's safety needs than they are themselves. They don't really know what they don't know. And for a lot of them, they're going to entrust in the fact that the most important thing is going to be met and you're gonna keep them safe. Because that's their greatest fear post injury and accident is to get re-injured. Maybe not to that great of a capacity, maybe they've ruled that out, but any sort of fear around any injury, they wanna make sure the practitioners that they've lent their hand to
is in a trustful and rapport building state where it's only an upward trajectory of health as opposed to a vast setback.
Brendan Aylward (01:11:54.467)
What was the vision that you had for your life before your accident? And what is it that you have now?
Hal Hargrave (01:12:02.59)
I could say there's two barometers that I have that define my pre-birth or my previous life and now the rebirth. Previous life, selfish vision. Take over a business that my father was involved in. Go to school, play baseball, fulfill the self-fulfilling accolades, live the college life.
I got injured at 17 a month and a half after graduation from high school. New version, new me, rebirth, vision for life is meaning and purpose around serving people. I have everything I need. Great family, great wife, beautiful daughter. I have a mission that I'm fulfilling. Value and purpose in my life to make this world a better place.
and I've recognized the people around me matter more than I do myself because they're the ones that give me the value and purpose. So my vision statement in the world is to see a world that isn't debilitated through the indifference of social customs to the wheelchair community living amongst the able-bodied community and that there's affordable access to safe healthcare.
that can allow people to recover. And my mission is not just to identify that challenge, but to be a part of the solution to solve it.
Brendan Aylward (01:13:37.615)
How do you want your work to influence the way that your daughter looks at the world and the world that she grows up in?
Hal Hargrave (01:13:48.81)
My daughter is a miracle in herself. My wife and I had four and a half years of infertility challenges. We incurred over 10 loss embryos. My wife stabbed herself with needles into her own flesh over 615 times to see this one being come to life. And we received a blessing.
And I don't want that to be the guilty connotation as she grows older to understand what a blessing she is and what it took to have her. But I want her to have awareness of focusing on the things she has rather than being so wrapped up in what she doesn't. Because in a world that is so divisive and in a world that can be very ugly sometimes.
Oftentimes it is the indifference that we face cognitively with the dissonance in our mind between our thoughts and our actions. And much of that stems from a focus on kind of this idea of jealousy, of looking around through social media and other social properties where we look at what others have and we either wish ill upon them or we wonder why they have that or why they're deserving of that.
and we start to look internally at what we don't have, and we think that we've been cursed when really all we've been is blessed. Your greatest blessing is your next breath, your ability to live in the here and now, to seek forth the opportunity to exercise your passions, to execute your vision, to make your mission.
a purposeful reality so others can live in a better world and a better place that you've been a part of for me. So I hope she takes forth the values of diversity, equity, and inclusion to not see a difference when she looks at somebody else that maybe she doesn't know their story, that she runs to curiosity first before she does judgment, that she tries to provide an equitable place and it may not always be equal, but equitable.
Hal Hargrave (01:15:48.754)
a place where it's accommodating, where maybe if somebody needs a ladder to reach something, you don't just have a six foot ladder there for everybody to use, but maybe you have a four foot and a 12 foot ladder because you're accommodating to people of different heights. So not only provide something, but have accommodations that curtail towards people that also want to be involved and also want to be contributed to the same things that matter to you.
I wanted to know that be passionate about your voice. You might think that you're one voice and what can one voice make in terms of a difference in this world? What does one vote make in terms of a difference in this world? Well, it's a very simple philosophy. You went out, you were at a park and you picked up a stick, you would break it. But if you picked up 10 sticks, could you break them? Build your collective. You are the sum of the closest people to you.
Don't get wrapped up in belief systems. The world is intended to divide. We look at this person, we say they believe differently. They chose red or they chose blue or they chose pro-life or not pro-life. There's controversial topics, all of which from our standpoint, the life we're living, the upbringing we were brought up in, they're right in our eyes. But we were all intended to believe different. But I wanted to focus rather on beliefs that somebody else has. Look at their morals, values, and ethics.
That will tell you who they are as a person. And generally speaking, we all want to be good people. We all don't want to kill. We all want to heal. We heal each other.
Brendan Aylward (01:17:33.527)
Yeah, well I would imagine your life in many ways is better because of your injury, not to imply that for you. Yeah, yeah. Yeah, and I hope that message reaches a lot of people. Maybe not even that are going through as traumatic of an experience as an SCI, but just how something negative can be turned into such a positive.
Hal Hargrave (01:17:44.295)
I'll spare you the words, yes. Yes, completely better.
Hal Hargrave (01:18:03.314)
I don't know how people can look at my accident and think it started negative. I think people see an accident as rejection, but really it's redirection. Like if I'm victimizing myself, maybe I look at my accident and I think, why did I get it the worst I could have got it? Well really I was given the blessing of continued life. Maybe amid the circumstances of my accident, I was given the best outcome I could have got.
Like, you might look at me and say, wow, you've been dealt a really bad hand, but I look at my hand and I say, I have a royal flush that I'm sitting with. Like, I don't know what you're seeing. Like, I have continued life, continued breath, continued purpose, what more do I need? My wife told me everything I needed to know on the altar.
during our vows, she said, I did not marry you on the account of whether or not you could walk. That did not determine the man you were. What determined who you were was your commitment, your loyalty, your value orientation, your confidence, your respect, your love, your healing, your presence. None of that had to do with my legs. If I could talk to the 17 year old version of me at time of my injury, I'd say.
it's gonna be okay. Because you're gonna have a community, you're gonna have friends, you're gonna have family, and you're gonna find the two things that we're all looking for in life, love and acceptance. And I found somebody that loves me, and she didn't even know me pre-accident, that she grew to love this version of me. I found acceptance there in and through her and in and through everybody like yourself. So I can live confidently in my skin. Like.
I'm living the holy grail and my accident was the one thing that was intended to happen to me and I always think, why not me? Not only am I built for this, but I'm going to recognize my blessings and not piss this second life away. It's too good to be true.
Brendan Aylward (01:20:11.307)
Yeah, I think more people should have you on their podcast, should share your message with their audiences. So I hope they take me up on that offer. And I hope you are okay with me promoting you in that way. If people want to connect with you, whether it's you personally or through the perfect step, or maybe those two things aren't always mutually exclusive, what's the best way or the best place for them to find you?
Hal Hargrave (01:20:39.474)
I'm never one for self-promotion, but if there is at all advocacy work involved with speaking for a broader community that maybe is outside of this office right now and believes they don't have a voice, that their opinion doesn't matter, that their story shouldn't be told because they believe it's a story of despair or pain or weakness, those are the same people I look at and say, how are you living through what you're living through? You're symbolic of strength and hope and a life worth living.
So if that's what you believe I can provide to you in the form of advocacy work, you can find me on Instagram, Hal Hargrave, Facebook, LinkedIn, send me an email, halhargrave at theperfectstep.com. You can check out our website, theperfectstep.com, press contact us, or even just reach out directly to Brendan. You are more than welcome to share the information if it's going to be a part of making the difference that I wanna see in this world. And that is a full reform at a foundational level
of what we start to believe diversity, equity, and inclusion is, and how we reform health care to give reimbursable health care to the things that our clients really want for themselves.
Brendan Aylward (01:21:51.803)
I'll include those pages, those links in the show notes for people to easily find. Hal, thanks again. This was an incredible conversation and I can't wait to share it.
Hal Hargrave (01:22:04.118)
You are an unbelievable host and I really felt like you brought out the vulnerable in me and only a good and seasoned vet could do that. So hats off to you, Brendan. I'm more than happy and honored to be a part of what we talked about today.